Renal replacement therapy modalities and techniques in intensive care units: An international survey

作者：Céline Monard, Arnaud Marel, Michael Joannidis, Marlies Ostermann, Zhiyong Peng, Kent Doi, Silvia De Rosa, Ilona Bobek, Д. В. Соколов, Vin‐Cent Wu, Vedran Premužić, Ravindra L. Mehta, Rinaldo Bellomo, Xaime García, Camilo Pizarro, Alexander Zarbock, Igor Milet, Thiago Reis, Marc Romain, Bairbre Mc Nicholas, Antoine Schneider, Thomas Rimmelé · 发表于：Journal of Critical Care · 年份：2025 · DOI：10.1016/j.jcrc.2025.155076 · 被引用次数：11 · 研究领域：Acute Kidney Injury Research、Dialysis and Renal Disease Management、Sepsis Diagnosis and Treatment

BACKGROUND AND HYPOTHESIS: Up to 14 % of critically ill patients receive renal replacement therapy (RRT) during their ICU stay and are treated with intermittent hemodialysis (IHD) or one of the continuous renal replacement therapy (CRRT) techniques. The choice of a modality (IHD or CRRT) and technique (continuuous veno-venous -hemodialysis (CVVHD), -hemofiltration (CVVH), or - hemodiafiltration (CVVHDF)), and the way it is delivered, may have an impact on outcomes but only few studies addressed this question. We aimed to survey the availability, settings, and clinicians' preferences regarding RRT modalities and techniques in critically ill patients. METHODS: Between July 2021 and March 2022, we conducted an open online worldwide survey targeting ICU clinicians and consisting of 31 questions. RESULTS: Among the 1174 participants from 73 countries, 94 % indicated their ability to initiate RRT at any time. CRRT was more widely available than IHD (97 % vs 85 %). CVVHDF was the most frequently used CRRT technique (59 %), followed by CVVHD (26 %) and CVVH (16 %). Most participants (70 %) reported having access to at least two CRRT techniques in their unit. Preference for IHD or CRRT varied greatly, depending on the clinical situation. Among CRRT techniques, CVVHD was preferred for removal of small-sized molecules, better hemofilter lifespan and reduced nursing workload. The preferential indications for CVVH included septic shock, removal of middle-sized molecules and fluid overload...